Medication-overuse headache(MOH) is one of the subtypes of secondary headache.It usually occurs on patients previously experiencing migraine or tension-type headache with symptomatic drugs overused frequently.Drugs for headaches can cause MOH.Compound analgesics containing caffeine may be the most common drugs in China.Proper instructions,careful education,compliance-enhancing and reasonable use of medication for preventing primary headache are necessary to withdraw the overused medication and thus to relive headaches and avoid relapse.

Objective To review the clinical features of chronic daily headache (CDH).Methods The clinical data of 128 patients with chronic daily headache,including general condition,characteristics of headache,concomitant symptom and disability were analyzed retrospectively.The features of primary chronic daily headache (PCDH) and medication over-dose headache (MOH) were compared.Results Among 128 cases females accounted for 79.7％ with an average age of 45.2 years and 88 patients were associated with drug overdose.The symptoms included nausea (68/128),photophobia (75/128),phonophobia (102/ 128),depression (77/128) and irritability (93/128),sleep disorders (94/128),dizziness (75/128),emotional irritability(58/128) and depression(21/128).The migraine disability assessment questionnaire and headache impact test-6 scores showed that disability was resulted from the severe degree of headache in 62.2％ (51/82) and 73.2％ (82/112) of CDH patients respectively.Compared with PCDH patients,the MOH patients had older age (t =2.59,P =0.011),longer duration (t =2.48,P =0.015) and severer degree of headache(t =5.58,P =0.018),and chronic migraine (t =11.95.P =0.001) was the most common primary headache type.Conclusions Most CDH patients are middle-aged women,with moderate to severe pain,usually complicated with depression,dysphoria and asomnia.Chronic daily headache patients are commonly associated with drug overdose.

Objective To study the effects of Duliang capsule on the expression of calcitonin gene‐related peptide(CGRP) and cholecystokinin(CCK) in the midbrain of a rat migraine model ,and explored treatment effects and mechanisms of Duliang cap‐sule on rats with migraine .Methods A total of 24 rats were randomly divided into four groups :normal control groups(A) ,migraine model groups(B) ,Duliang capsule control groups(C) and Duliang capsule treatment groups(D) .C and D were intragastrically per‐fused with Duliang capsule(0 .5 g · kg -1 · d-1 ) .After 7 days ,nitroglycerin was subcutaneously injected into the buttocks of the B and D to induce migraine .Two hours after nitroglycerin injection ,the midbrain were isolated CGRP and CCK expression in midbrain were determined using SYBR Green I real‐time quantitative PCR .Results CGRP mRNA expression was significantly lower in mid‐brains of rats in the Duliang capsule treatment groups compared with migraine model groups(P<0 .05) .CCK mRNA expression was significantly lower in midbrains of rats in the Duliang capsule control groups compared with normal control groups(P<0 .05) . Conclusion Duliang capsule can exhibit the expression of CGRP and CCK in the midbrain of the migraine rats .weaken the CGRP and CCK‐induced inhibition of the analgesic effects of opioid peptides .

Objective To observe the pathological changes of hippocampus and myelin in rats with frontal cereberal ischemia and reperfusion after treated with methylcobalamine and to discuss the mechanism of the cerebral protective effect of methylcobalamine.Methods Cerebral ischemia and reperfusion models were made by clamping bilateral carotid arteries.Forty-five male Wistar rats were randomly allocated to sham-operation group,ischemia-reperfusion group and methylcobalamine group(n=15).1,2,4 weeks after reperfusion the rats in each group were divided into three groups(n=5).The pathological changes of hippocampus and myelin were observed by using light microscope,HE staining,LFB staining and electron microscope.Results The pyramidal neurons in hippocampus in ischemia and reperfusion groups expressed putrescence and myelin necrosis or demyelination at 1st week,and the histomorphological changes at 4th week were significant than that at 2nd week.The followings were observed in electron microscope: dimness,partly solubilization and collapsablity in myelin.The pyramidal neurons in hippocampus of therapy groups were similar to normal one and myelin expressed compaction and shipshape.The changes were more obvious at 4th week.Conclusion Methylcobalamine can obviously decrease the ischemia lesion of hippocampus and myelin and protect the brain function.

OBJECTIVE:To observe the therapeutic effect of compound glycyrrhizin on ulcerative colitis.METHODS:165cases of ulcerative colitis were divided into two groups:trial group(compound glycyrrhizin)and control group(sulfasalazine). The clinical effects were compared between two groups.RESULTS:The total effective rates were92.38%in trial group and65%in control group(P

Objective This study assesses the influence of rizatriptan on calcitonin gene-related peptide (CGRP),proenkephalin (PENK) and cholecystokinin (CCK) mRNA expressions in the trigeminal ganglia of a rat migraine model and investigates the possible mechanisms by which triptans treat migraine.Methods A total of 24 rats were randomly divided into four groups:normal control group (A),migraine model group(B),rizatriptan control group (C) and rizatriptan treatment group(D).Groups C and D were intragastrically perfused with rizatriptan,1 mg/kg per day.After 7 days,nitroglycerin was subcutaneously injected into the buttocks of the groups B and D to induce migraine.Two hours after nitroglycerin injection,the trigeminal ganglia was isolated.CGRP,PENK and CCK mRNA expressions in the trigeminal ganglia were determined using SYBR Green Ⅰ real-time quantitative PCR.Results The copy number of CGRP mRNA (× 107) in 200 ng total RNA of each group was 0.05 ±0.01,1.30 ±0.52,0.23 ±0.12,0.43 ±0.33 ; The copy number of PENK mRNA (× 103) in 200 ng total RNA of each group was 3.30 ± 1.65,0.34 ±0.14,3.91 ± 2.44,0.71 ± 0.13.The copy number of CGRP mRNA in the trigeminal ganglia of group B was significantly higher than that of group A (q =7.854,P ＜ 0.05) ; CGRP mRNA expressions were significantly lower in the trigeminal ganglia of rats in group D compared with group B (q =5.458,P ＜0.05).Compared with group A,PENK mRNA expressions in the trigeminal ganglia of rats were significantly lower in group B (q =4.478,P ＜ 0.05).PENK mRNA expressions were significantly higher in trigeminal ganglia of rats in group C compared with group D (q =4.838,P ＜ 0.05).CCK mRNA expression in trigeminal ganglia of rats was similar among groups.Conelusions Rizatriptan can decrease the expressions of CGRP in the trigeminal ganglia of the migraine rats and exhibits neurogenic inflammation triggered by CGRP.PENK expressions decrease in the trigeminal ganglia of the migraine rats,weaken the analgesic effects of enkephalin.

Objective To observe the influence of rizatriptan on the behavior and pain-related cytokines in peripheral blood of the migraine model rats, and to investigate the theraputic effect of rizatriptan on migraine.Methods A total of 24 rats were randomly divided into:control group,migraine group,rizatriptan control group and rizatriptan treatment group.The rats in rizatriptan control and rizatriptan treatment groups were intragastrically perfused with rizatriptan,1 mg·kg-1 per day (according to the adult daily dose),and the rats in control and migraine groups were perfused with normal saline,1 mL per day. After 7 d, nitroglycerin was subcutaneously inj ected into the buttocks of the rats in rizatriptan treatment and migraine groups to induce migraine.Normal saline was injected into the rats in control and rizatriptan control groups.At 60-90 min following nitroglycerin injection,the total number of behavioral symptoms was measured.The serum calcitonin gene-related peptide(CGRP),5-hydroxytryptamine (5-HT ), interleukin-1β(IL-1β), and tumor necrosis factor-α(TNF-α) levels were determined using ELISA. Results Compared with migraine group, the behavioral score of the rats in rizatriptan treatment group was significantly decreased (P<0.05).The serum CGRP level of the rats in migraine group was significantly higher than that in control group (P<0.05).Compared with control group,the serum 5-HT level of the rats in and migraine group was decreased, but there was no significant differece (P>0.05 );the serum 5-HT level in rizatriptan control group was significantly increased(P<0.05).The serum 5-HT level of the rats in rizatriptan treatment group was significantly increased compared with migraine group (P<0.05).The serum IL-1βand TNF-αlevels of the rats in varions groups had no significant differences (P>0.05).Conclusion Rizatriptan can relieve the behavior symptoms in nitroglycerin-induced migraine model rats, increase the serum 5-HT level, improve the vasomotor disturbance,and relieve the angiectasis.

Objective To assess the influence of Rizatriptan on the cholecystokinin( CCK) expression in periaqueductal gray( PAG) of migraine model rat to investigate the possible mechanism by which Triptans treat mi?graine. Methods A total of 24 rats were randomly divided into four groups:normal control groups(A),migraine model groups(B),Rizatriptan control groups(C) and Rizatriptan treatment groups(D).C and D groups were intra?gastrically perfused with Rizatriptan,1 mg/kg per day. After 7 days,nitroglycerin was subcutaneously injected into the buttocks of the B and D group to induce migraine. Two hours after nitroglycerin injection,the trigeminal ganglia were isolated.CGRP expression in periaqueductal gray were determined using SYBR Green I real?time quantitative PCR and Immunohistochemistry. Results CCK mRNA levels ( target gene mRNA copies per 250 ng total RNA,× 106) in the rat midbrain of A,B,C,D groups were 1.25±0.41,1.71±0.93,0.17±0.12,0.22±0.07 respectively. CCK?8?immunoreactive positive cells in the rat PAG of each group were 37.17±12.62,40.17±11.09,27.33±7.71, 20.67±7.66 respectively. CCK mRNA expression in group C was significantly lower than that of group A(P<0.05) while the CCK mRNA expression in group D was lower than that of group B(P<0.05).The CCK?8?positive cells of the rat PAG in group D were lower than that in group B(P<0.05) . Conclusion Rizatriptan can down regulate the expression of CCK?8 in the PAG of the migraine rats and weaken the CCK?8 induced inhibition of the analgesic effects of opioid peptides.

Objective To observe the effects of estrogen on behavior and 5-HT in periaqueductal gray (PAG)in migraine model rats. Methods Tewnty-four ovariectomized Wistar rats were divided randomly into four groups:control group (Group A),migraine group(Group B),low dose estradiol-treated ovariectomized group(Group C),high dose etradiol-treated ovariectomized group(Group D).After 1 week,the rats in Group B,C and D were injected with nitroglycerine 10 mg?kg-1 subcutaneously to make migraine rat models,the rats in Group A were given peanut oil alike,and the behavior changes were observed.2 h after injection,the rats were killed and the midbrains were separated and then 5-HT immunohistochemical staining was performed.Results Behavior: compared with Group B,the degrees of red-calws,red-ears and red-tail rats in Group D relieved obviously,the times of climbing hutch and scratching head were much fewer,while the rats in group C showed no significant difference;Immunohistochemical staining:compared with Group A,the 5-HT-positive neurons expression in PAG of Group B and C were more obviously(P

Objective:To study the effect of 3-n-butylphthalide (NBP) on the expression of brain-derived neurotrophic factor (BDNF) in the hippocampal CA1 region of the vascular dementia (VD) rats,and to explore its protective effect on VD.Methods:Eighty healthy Wistar rats were equally and randomly assigned to sham operation group,NBP control group (sham operation + NBP injection),VD group (VD models),NBP treatment group (VD models + NBP injection) (n=20).Each group was divided into four subgroups (n =5):1,2,4,and 8 weeks after operation groups.The VD rat models were established by using permanent bilateral common carotid artery ligation.After consciousness,the rats in NBP treatment group and NBP control group were intraperitoneally injected with 5 mg · kg-1 · d-1 NBP for consecutive 7 d.The rats in VD and sham operation groups were intraperitoneally injected with 0.2 mL · d-1 saline for consecutive 7 d.At 1,2,4,and 8 weeks after operation,the rats in each group were decapitated.The brains were obtained,and then the hippoeampus tissues were isolated.The BDNF expression levels in the hippocampal CA1 region were determined using real-time quantitative PCR and immunohistochemistry methods.Results:At 2,4,and 8 weeks after s operation,the expression levels of BDNF mRNA in the hippocampus of the rats in VD group were significantly higher those in sham operation group (P＜ 0.05);at 4 and 8 weeks after operation,the expression levels of BDNF mRNA in the hippocampus of the rats in NBP treatment groups were significantly higher than that in VD group (P＜ 0.05).The immunohistochemistry results showed that the expression level of BDNF protein in the hippocampal CA1 region of the rats in VD group was higher than that in sham operation group at 4 weeks after operation (P＜ 0.05);the expression level of BDNF protein in the hippocampal CA1 region of the rats in NBP treatment group was higher than that in VD group at 8 weeks after operation (P＜0.05).Conclusion:The BDNF expression is increased in the hippocampal CA1 region of the rats with VD after the neurons were injured by ischemia.NBP can increase the BDNF expression level in the hippocampal CA1 region of the VD rats and protect the nerves.